PURPOSE. To functionally evaluate novel human sequence-derived candidate genes and variants for unsolved ocular congenital cranial dysinnervation disorders (oCCDDs). METHODS. Through exome and genome sequencing of a genetically unsolved human oCCDD cohort, we previously reported the identification of variants in many candidate genes. Here, we describe a parallel study that prioritized a subset of these genes (43 human genes, 57 zebrafish genes) using a G0 CRISPR/Cas9-based knockout assay in zebrafish and generated F2 germline mutants for 17. We tested the functionality of variants of uncertain significance in known and novel candidate transcription factor-encoding genes through protein binding microarrays. RESULTS. We first demonstrated the feasibility of the G0 screen by targeting known oCCDD genes phox2a and mafba. Approximately 70% to 90% of gene-targeted G0 zebrafish embryos recapitulated germline homozygous null-equivalent phenotypes. Using this approach, we then identified three novel candidate oCCDD genes (SEMA3F, OLIG2, and FRMD4B) with putative contributions to human and zebrafish cranial motor development. In addition, protein binding microarrays demonstrated reduced or abolished DNA binding of human variants of uncertain significance in known and novel sequence-derived transcription factors PHOX2A (p.(Trp137Cys)), MAFB (p.(Glu223Lys)), and OLIG2 (p.(Arg156Leu)). CONCLUSIONS. This study nominates three strong novel candidate oCCDD genes (SEMA3F, OLIG2, and FRMD4B) and supports the functionality and putative pathogenicity of transcription factor candidate variants PHOX2A p.(Trp137Cys), MAFB p.(Glu223Lys), and OLIG2 p.(Arg156Leu). Our findings support that G0 loss-of-function screening in zebrafish can be coupled with human sequence analysis and protein binding microarrays to aid in prioritizing oCCDD candidate genes/variants.

Background: This study aimed to identify optical coherence tomography (OCT) biomarkers for predicting response to anti-VEGF treatment in diabetic macular edema (DME) Methods: Bilateral DME patients with asymmetric response to a loading dose of anti-VEGF (ranibizumab/aflibercept) treatment were retrospectively studied. The morphologic response criterion was central subfield thickness (CST) <= 300 mu m; asymmetric response was defined as >= 10% difference in CST reduction between the eyes. The functional response criterion was an increase in logMAR acuity of >= 3 lines, with an increase below this threshold in the fellow eye considered asymmetric response. Relationships between final morphologic and functional responses to anti-VEGF therapy and baseline values of the following OCT-derived biomarkers were evaluated: DME subtype, CST, vitreoretinal interface anomalies, disorganization of the inner retinal layers (DRIL), external limiting membrane (ELM) disruption, ellipsoid zone (EZ) disruption, and subretinal fluid (SRF). Results: After a loading dose of anti-VEGF, 31 eyes that met both morphologic and functional response criteria were classified as responders (RR) and 27 eyes that did not respond morphologically or functionally based on the defined criteria were classified as resistant (RT). Eyes that showed only functional (n = 5) or morphological response (n = 1) were excluded due to their small number. The presence of SRF or simple epiretinal membrane (ERM) was not associated with any difference in treatment responses (p > .05), while tractional ERM, extensive DRIL (>= 500 mu m), and ELM and EZ disruptions in the fovea-centered 1000-mu m zone were important OCT biomarkers in predicting resistance (p < .001). A multilayer perceptron model ranked predictive power as 100% for ELM disruption, 51.7% for tractional ERM, 25.4% for DRIL, and 24.5% for EZ disruption. Conclusion: Extensive ELM disruption was the strongest OCT biomarker to predict anti-VEGF resistance, followed by tractional ERM. EZ disruption and DRIL had relatively lower predictive value

Objective:The purpose of this study is to determine the effect of latent strabismus on stereoacuity.Methods: Stereoacuities of normal individuals, ranging in age from 18 to 35 years, were measured using the TNO or Titmus tests.The study population was divided into 2 groups regarding the achievement of the accepted excellent stereoacuity threshold of 30 arcseconds (group A) or not (group B).The relationship between latent deviation angles and stereoacuity levels were evaluated.Results: Latent deviation angles ranged from 0 to 35 prism diopters (PD).Both TNO (r=0.380p=0.002) and Titmus (r=0.306p=0.015) stereothresholds tended to increase as the latent deviation angles increased.Group A included 27 participants who had either exophoria (18) or orthophoria (9), and the mean deviation angle of this group was 3.07±3.26PD.Group B included 36 participants, 28 of whom had exophoria, three had esophoria, and the remaining five had orthophoria.The mean angle of deviation in group B was 6.50±6.92PD.This value was statistically higher than the mean deviation angle in group A (p=0.012).Though none of the esophoric participants achieved excellent stereoacuity, the distribution of the deviation types did not cause any difference between the groups (p=0.077).The mean age of group A was found to be higher than that of group B (p=0.006). Conclusion:Latent deviation can mask true stereosensitivity potentials of subjects to some extent during the stereotesting procedure.

ÖZET Bu çalışmada, sırasıyla tek ve çift taraflı superior oblik felcini taklit eden bir oküler miyastenia gravis olgusu sunularak, superior oblik felcinin ayırıcı tanısında oküler miyastenia gravisın dikkate alınması gerektiği vurgulanmak istenmiştir. Bir yıldır devam eden çift görme şikâyeti olan 53 yaşındaki erkek olgu, sağ superior oblik felci tanısı almış ve cerrahi planlanmıştı. İkinci bir görüş için gelen olguya primer pozisyonda sol intermittan hipertropya ve ekzotropya saptandı ve üç basamak testi ile bilateral superior oblik felci tanısı konuldu. Subjektif torsiyon yoktu, ancak çift Maddox testinde 10°ekstorsiyon saptandı. Takipte, üç ay içinde göz hareketleri tüm yönlerde kısıtlanma ve sağ pitozis gelişti. Pupil tutulumu olmayan hastada bu bulgularla oküler miyastenia gravisten şüphe edildi. Pitozisin buz testi ile tamamen düzelmesi ile oküler miyastenia gravis tanısı konuldu. Superior oblik felci, vertikal şaşılığın en sık izlenen nedenidir. Ancak ayırıcı tanıda oküler miyastenia gravis akılda tutulmalı ve klinik stabilite gözlemlenmeden tedavi planlanmamalıdır.

To investigate the effects of partial and full correction of refractive errors on sensorial and motor outcomes in children with refractive accommodative esotropia (RAE).

Familial exudative vitreoretinopathy (FEVR) is a rare inherited disorder of retinal angiogenesis. A 49-year-old male patient was referred to our clinic for retinal vascular occlusion. His history, clinical findings, and fundus fluorescein angiography findings were evaluated. Family members were called and eye examinations were performed. Our patient was not born preterm and he reported decreased visual acuity after a traffic accident during childhood. He had laser treatment when he was 12 years old and again 1 month before our examination. He also had laser-assisted in situ keratomileusis surgery for both eyes in 2002. On examination, his visual acuity was 0.4 in the right eye and 0.3 in the left eye. He had cortical cataract in both eyes. Macula OCT revealed macular contour irregularity due to epiretinal membrane in his right eye and minimal perifoveal thinning in his left eye. On fundus photography, straightening of the retinal vessels, macular dragging, retinal folds on temporal retina, preretinal fibrosis, and laser spots were seen. FFA revealed avascular retinal areas with incomplete laser spots in the temporal, inferior, and superior parts of retina. He also had neovascularization with leakage in the temporal retina of his right eye. The patient’s brother, who was also born at full term, also had excessive branching of the vascular structures in the temporal peripheral retina, non-perfused cord vessels and avascular areas. In light of all these findings, we diagnosed our patient with Stage 2A FEVR and his brother with Stage 1 FEVR. In summary, FEVR is a clinically diagnosed disease. Because FEVR is inherited and potentially sight-threatening, family examination is helpful and important so that affected family members can be diagnosed and followed up.

BACKGROUND:Data from Turkey show that sense organ diseases were the second leading cause of years lost due to disability in 2015. However, there are no reliable data on either the baseline causative disorders of visual impairment or the burden of these disorders on the population in Izmir region. Izmir is the third most populated city of Turkey with a population of approximately 4.2 million.AIM:The purpose of this study was to define the baseline disorders causing low vision and blindness in accordance with World Health Organization criteria in an adult population in Izmir.METHODS:We evaluated the ophthalmologic reports of 20 790 people in Izmir, Turkey. Age- and sex-specific causes of low vision and blindness were identified.RESULTS:Bilateral low vision and blindness was detected in 347 people, 172 males and 175 females. For those aged 18-50 years, retinal dystrophies (37%), congenital eye anomalies (14%) and myopic degenerations (13%) were the most common causes. For those aged 50+ years, age-related macular degeneration (21%) was the leading cause. Diabetic retinopathy (17%), corneal opacities (14%), cataract (12%) and glaucoma (9%) were also important. Sex was not a significant determinant.CONCLUSION:The specific causes of visual impairment vary greatly with age, however, unavoidable retinal pathologies were the predominant causes at all ages.

PURPOSE:To evaluate the correlation between weight reduction and visual outcome in overweight patients with idiopathic intracranial hypertension.METHODS:Thirty-nine newly diagnosed, overweight (body mass index >25 kg/m2) patients with idiopathic intracranial hypertension were studied retrospectively. All patients underwent medical treatment with acetazolamide, and a weight reduction program was also offered. Patients were grouped according to their compliance with this weight reduction program into the diet-success (Group 1) and diet-failure groups (Group 2). Body mass index, papilledema, visual acuity, and perimetric mean deviation were compared at the end of the 6-month study period.RESULTS:Groups 1 and 2 did not differ regarding the baseline mean body mass index (32.63 ± 5.61, 32.35 ± 5.06 kg/m2), visual acuity (0.080 ± 0.13, 0.130 ± 0.24 logMAR), perimetric mean deviation (-9.978 ± 0.68, -12.86 ± 8.91), or papilledema grade (2.94 ± 0.22, 2.90 ± 0.30), respectively (p>0.05). During the 6 months' follow-up, Group 1 patients, who complied with both medical and diet therapy, improved significantly in all parameters, including body mass index (p<0.001), visual acuity (p=0.001), perimetric mean deviation (p=0.016), and papilledema grade (p<0.001). Conversely, Group 2 patients, who only underwent medical therapy, improved only in papilledema grade (p<0.001). However, coincident development of optic disc pallor was observed in three patients. Further, they also had significant loss in visual acuity (p=0.047) during the study period.CONCLUSION:Weight reduction combined with medical treatment is associated with significantly better improvement in visual acuity, visual field, and papilledema in idiopathic intracranial hypertension patients. Compliance with an efficient diet program should be encouraged in overweight patients with idiopathic intracranial hypertension.

To evaluate the etiology and possible prognostic factors affecting the visual outcome in patients with indirect traumatic optic neuropathy (TON).

Introduction: Aging of the population leads to an increasing number of older people with a severe disability, in need of long-term care, which is a major public health problem. Herein, we attempted to find out the main pathologies that cause severe disability, including neuromusculoskeletal disability, in elderly and young adults. Materials and Method: In this descriptive observational study, we retrospectively reviewed the medical records of 20,790 subjects admitted to the Health Council of the Izmir Ataturk Training and Research Hospital over the last two years. Subjects identified as severely disabled and >18 years old were in cluded. Age-(19-64 or 65+ years) and gender-specific causes of severe disability were identified. Results: Overall, 1,117 (631 female, 486 male) subjects were severely disabled. Mean age was 65.9 +/- 18.1 years; 60% were >65 years old. Main pathologies leading to severe disability were nervous system (61%), eye (11%), mental and behavioral (9.3%), musculoskeletal (8.4%), neoplasms (2.8%), respiratory (2.7%) and other diseases. Distribution of the pathologies were statistically different between age subgroups (p<0.001), but not between gender subgroups (p>0.05). Dementia and stroke were the most frequent neurological conditions. Knee osteoarthritis was the leading musculoskeletal cause of severe disability. Conclusion: This study may provide a baseline indication of pathologies commonly causing severe disability. Most severely disabled subjects were female and of older age. Neurological diseases were the most frequent causes of severe disability. Preventive and rehabilitative health service planning should be undertaken to decrease the disability caused by these conditions.

The purpose of this study was to describe a patient of orbital apex syndrome, anterior uveitis, secondary glaucoma, corneal dellen, and necrotizing scleritis following an attack of herpes zoster ophthalmicus, and the placement of a pericardial patch graft. A 64-year-old male patient with blepharoptosis of his right eye and multiple vesicles on the forehead, nose and cheeks, limitation on all gazes, blepharoptosis, and exophthalmia was eventually diagnosed with ophthalmic zona with orbital apex syndrome. After the treatment with systemic antiviral and steroid, there was complete recovery of the unilateral vesicular eruption, ophthalmoplegia, and ptosis at the third month follow-up. However, anterior uveitis, necrotizing scleritis, secondary glaucoma, and corneal dellen developed during follow-up. At the ninth month, pericardial patch graft (Tutoplast) was placed due to progression of the scleral thinning. Graft vascularization was completed. Careful and long-term follow-up of patients with ophthalmic zona is required for possible ophthalmic complications of varicella zoster virus infections. A pericardial patch graft might be placed due to the development of necrotizing scleritis.

Purpose: To evaluate the optic nerve head parameters and peripapillary retinal nerve fiber layer using spectral-domain optical coherence tomography (SD-OCT) in a systemic sclerosis (SSc) cohort and age-matched controls to determine whether SSc patients have an increased risk of normal-tension glaucoma (NTG).Methods: We examined 30 patients (3 male, 27 female) with SSc and 28 age-and sex-matched controls. Retinal nerve fiber and optic disc morphology were evaluated using Cirrus SD-OCT.Results: Optic disc morphology measurements including disc area, rim area, average and vertical cup/disc (C/D) ratio, and cup volume were not significantly different between the study groups. The average and 4-quadrant retinal nerve fiber layer (RNFL) measurements of the C/D >0.3 subgroups were not significantly different in the patients and controls. These values were also similar for the C/D >0.5 subgroups except that the average inferior quadrant RNFL thickness of the right eyes in the patient subgroup was significantly thinner than in the control subgroup (p<0.05).Conclusions: Our SSc cohort had relatively shorter disease duration but increased prevalence of early glaucomatous damage signs. Our findings indicate that SSc is a risk factor for developing normal-tension glaucoma. Further studies combined with visual field evaluation are necessary to identify the long-term glaucomatous effects of SSc.

To report the causes of persistent inferior oblique (IO) overactions after disinsertion procedure.

The purpose of this study was to determine the predictors of stereoacuity outcome in visually mature subjects with exotropia following surgical correction. Visually mature subjects who were surgically aligned and had been tested for stereoacuity in the postoperative period were studied retrospectively. Subjects were grouped with respect to their responses to Titmus or TNO stereotests. Characteristics such as amblyopia, anisometropia, and characteristics of the exodeviation such as time of onset, duration, intermittency, presence of an A or V pattern, distance-near disparity, coexisting vertical deviation, and inferior oblique overaction, were compared between the groups. One hundred and four visually mature subjects with exotropia met the inclusion criteria. Stereoacuity was achieved in 77% of the study group and only 9% of these could achieve fine stereoacuity. Negative stereoacuity was more frequently associated with larger deviation angles, higher anisometropia, inferior oblique overaction, pattern strabismus, coexisting vertical strabismus, and distance-near disparity, but not at a statistically significant level. The optimal cutoff for strabismus duration was 20 years for a positive stereoacuity outcome. Any-level visual acuity difference was found to decrease the chance for positive stereoacuity significantly. The odds ratios for the stereoacuity positivity were 4.05 for strabismus duration <20 years, 7.9 for strabismus onset >1 year of age, 3.79 for weaker eye visual acuity >20/25 and 9.85 for intermittency of strabismus. Intermittence of exotropia was the strongest predictor for positive stereoacuity. Exotropia onset after 1 year of age, absence of any-level visual acuity difference, and strabismus duration <20 years were the other predictors with decreasing power.

Amaç: Bu çalışmanın amacı, katarakt cerrahisi sonrasında ortaya çıkan nonarteritik anterior iskemik optik nöropati (NAAİON) olgularını değerlendirmektir. Gereç ve Yöntemler: Aralık 1999-Mayıs 2015 tarihleri arasında senil katarakt nedeni ile ameliyat olup, erken dönemde NAAİON geçiren olgular dosya kayıtlarından geriye dönük olarak incelendi. Ayrıntılı nörooftalmolojik ve sistemik muayeneleri ile NAAİON tanısı alan, diğer optik nöropatiler ile ayırıcı tanıları yapılan olgular olası risk faktörleri ve katarakt cerrahisi ile bağlantıları doğrultusunda araştırıldı. Bulgular: Senil katarakt nedeni ile ameliyat edilerek göz içi lens implantasyonu sonrasında NAAİON geçiren toplam 11 olgunun 12 gözü çalışmaya alındı. Olguların 6 (%55)'sı kadın, 5 (%45)'i erkek, yaş ortalaması 70,6±6,3 (sınırlar; 62-82) yıl olarak saptandı. Göz dibi muayenelerinde olguların hepsinde küçük optik disk ve küçük fizyolojik çukurluk izlendi. Olası sistemik risk faktörleri olarak 5 olguda (%45) diabetes mellitus (DM), 2 olguda (%18) hipertansiyon, 2 olguda (%18) hiperlipidemi, 1 olguda (%9) koroner arter hastalığı ve 1 olguda (%9) anemi tespit edildi. Nonarteritik anterior iskemik optik nöropatili gözlerin 4 (%33)'ü topikal, 8 (%67)'i retrobulber lokal anestezi altında ameliyat edildi. 6 (%50)'sına komplikasyonsuz ekstrakapsüler, 6 (%50)2sına fakoemülsifikasyon cerrahisi uygulandı. Katarakt cerrahileri sonrasında NAAİON gelişme zamanı 5. gün ile 5. ay arasında, görme dereceleri Snellen eşelinde 0,01 ile 0,1 arasında değişmekteydi. İzlem süresi ortalama 22,8±26,9 (sınırlar; 6-96) ay olan olguların son muayenelerindeki görme dereceleri Snellen eşelinde 0,03 ile 0,3 arasında idi. Sonuç: Katarakt cerrahisini takiben gelişen NAAİON'nin cerrahiye bağlı olup olmadığı tartışmalı olmakla birlikte, cerrahi sonrasında ani görme azlığı tanımlayan olgularda NAAİON gelişme olasılığı düşünülmelidir.

BACKGROUND:The aim was to investigate the morphological changes in the fovea and choroid in patients with scleroderma and its systemic associations.METHODS:Thirty-four scleroderma patients and 31 healthy controls were enrolled. Choroidal thickness (CT) at five defined points (subfoveal [sfCT] and 1.0 [N1.0] and 3.0 µm nasal [N3.0] and 1.0 [T1.0] and 3.0 µm temporal [T3.0] from the centre of the fovea) and central foveal thickness were measured.RESULTS:The mean central foveal thickness (right eye 229.3 ± 28.6 versus 232.6 ± 29.7 and left eye 219.8 ± 21.4 versus 223.3 ± 21.9 µm) and sfCT (right eye 326.4 ± 56.5 versus 327.3 ± 62.1 and left eye 316.7 ± 53.4 versus 317.6 ± 51.6 µm) values were not different in patients with scleroderma compared with the controls (p > 0.05). The mean CT at N1.0, N3.0, T1.0 and T3.0 did not differ among these groups in both eyes (p > 0.05). There was no difference in the mean central foveal thickness and CT of both eyes in diffuse and limited scleroderma (p > 0.05). A negative correlation was found between anti-nuclear antibody positivity and CT at T3 and N3 (respectively, r = -0.439 and r = -0.383, p < 0.05).CONCLUSION:Choroidal thickness at five points and central foveal thickness in both eyes did not significantly differ in scleroderma patients compared with healthy controls. Choroidal thickness at the T3 and N3 points showed a negative correlation with anti-nuclear antibody positivity.

Amaç: Simetrik ve asimetrik cerrahi sonrası başarılı primer ekzotropya hastalarında cerrahi miktarlara verilen yanıtların değerlendirilmesidir. Gereç ve Yöntemler: Temmuz 2001-Ocak 2014 tarihleri arasında iki taraflı dış rektus geriletmesi (simetrik cerrahi) ve tek taraflı dış rektus geriletmesi ile iç rektus kısaltması (asimetrik cerrahi) geçiren primer ekzotropyalı hastaların kayıtları incelendi. Simetrik (Grup 1) ve asimetrik (Grup 2) başarılı hastalarda cerrahi miktarlara verilen yanıtlar ve etkileyen faktörler araştırıldı. Bulgular: Grup 1 (n=31) ve Grup 2 (n=34) hastaları arasında cerrahi yaşı, cinsiyet, ambliyopi oranı, cerrahi miktarlar, cerrahi sonrası kayma açıları ve izlem süreleri açısından fark saptanmadı (p>0,05). Grup 1?de hastalarında anizometropi (p=0,011) ve cerrahi öncesi kayma açıları (p=0,001) Grup 2 hastalarına göre az, binoküler görme (p=0,036) ve görme keskinliği (p=0,014) daha iyiidi. Cerrahi sonrası binoküler görme artışı, öncesine göre her iki grupta anlamlıidi (p=0,001). Grup 1?de 1 mm geriletmenin yakında 2,11±0,66 (1,08-3,67) prizma dioptri (PD), uzakta 2,41±0,65 (1,43-3,83) PD; Grup 2?deki hastalarında ise 1 mm geriletme ve kısaltmanın yakında 3,27±0,71 (1,74-4,37) PD, uzakta 3,54±0,66 (2,17-4,78) PD?lik düzeltme yaptığı saptandı (p<0,05). Cerrahi öncesi yakın ve uzak kayma açılarının, cerrahi sonrası binoküler görme ve cerrahi yöntem değişkenlerinin cerrahi yanıtlar üzerindeki etkisi anlamlıidi. Etki büyüklüğü açısından cerrahi öncesi kayma miktarlarının en anlamlı etkiye sahip olduğu, kayma açısıyla birlikte yanıtların arttığı görüldü (p<0,05). SSoonnuuçç:: Ekzotropya hastalarında klinik özelliklerine göre simetrik veya asimetrik cerrahi tercih edilebilir. Her kliniğin kendine ait doz-yanıt sonuçlarını gözden geçirmesi gerekmektedir.

To evaluate main numerical parameters of anterior segment and the effects of eyelid skin changes on these parameters in patients with systemic sclerosis (SSc). Thirty-four patients with SSc and 34 healthy individuals were enrolled. Besides full eye examination, anterior segment measurements including anterior chamber depth (ACD), anterior chamber volume, anterior chamber angle width, central corneal thickness, pupil size, corneal volume and keratometry were obtained using a Sirius Scheimpflug/Placido photography-based topography system. Eyelid thickness was evaluated using the scala of the modified Rodnan skin score and the patients were subgrouped with respect to these scores to evaluate the effect of eyelid thickening on the anterior segment parameters. Age and sex distributions of the groups were similar (p > 0.05). SSc patients had steeper and thinner corneas, smaller corneal volumes, narrower, shallower and smaller anterior segments but only the mean ACD value of right eyes was found significantly less than those of the controls (p = 0.047). The mean ACD values of SSc subgroup patients with moderate to severe eyelid thickening (50 %) had lower ACD measurements compared to those of control group. (p = 0.043 for the right eyes, p = 0.070 for the left eyes). However, SSc subgroup patients with none to mild eyelid thickening (50 %) had similar anterior segment parameters with control subjects (p > 0.05). Anterior chamber parameters of the SSc patients could show significant differences. These differences occur parallel to the eyelid changes but not secondary to it.

OBJECTIVES:To evaluate the results of symmetric and asymmetric surgery and responses to surgical amounts in patients with infantile esotropia. MATERIALS AND METHODS:The records of patients with infantile esotropia who underwent bilateral medial rectus recession (symmetric surgery) and unilateral medial rectus recession with lateral rectus resection (asymmetric surgery) were analyzed. The results of the cases with symmetric (group 1) and asymmetric (group 2), successful (group 3) and failed (group 4) surgeries were compared, and responses to the amount of surgery were investigated. RESULTS:There were no significant differences between group 1 (n=71) and group 2 (n=13) cases in terms of gender, refraction, preoperative distance deviation, anisometropia and postoperative deviation angles, binocular vision, surgical success or follow-up period (p>0.05). The rate of amblyopia, near deviation and amount of surgery were higher in group 2 cases (p<0.05). Between group 3 (n=64) and group 4 subjects (n=20), no significant differences were detected in terms of gender, surgical age, refraction, amblyopia, anisometropia, preoperative deviation angles, the number of symmetric and asymmetric surgeries, the amount of surgery, or postoperative binocular vision (p>0.05). The average postoperative follow-up period was 15.41±19.93 months (range, 6-98 months) in group 3 cases and 40.45±40.06 months (range, 6-143 months) in group 4 cases (p=0.000). No significant difference was detected in the amount of deviation corrected per 1 mm of surgical procedure between the successful cases in the symmetric and asymmetric groups (p>0.05). CONCLUSION:Symmetric or asymmetric surgery may be preferable in patients with infantile esotropia according to the clinical features. It is necessary for every clinic to review its own dose-response results.